Evaluating the provision of health services in Australia involves bringing together a number of different types of information. While large amounts of data in relation to health service usage are available from Medicare, the Pharmaceutical Benefits Scheme (PBS) and public hospital collections, these sources are designed primarily for administrative purposes and do not provide representative population level statistics, particularly in relation to issues such as unmet need for services. In addition, while growing worldwide interest in capturing information from a patient's perspective has encouraged hospitals to collect patient experience data in Australia, these collections are limited to local coverage and do not support robust national reporting.

Two ABS collections, the National Health Survey (NHS) and Patient Experience Survey (PEx) address these issues directly and provide information on health service usage and experience of care in Australia. Introduced in 2009, the PEx provides data on access and barriers to a range of health services, complementing data on visits to general practitioners (GPs) and other selected health professionals collected in the NHS.

This section presents self-reported information on health service usage and experiences of Australians aged 15 years and over for their own health. The reference period is the 12 months prior to the 2010–11 PEx, unless otherwise specified. Data were only collected from people living in private dwellings.

Administrative data on health service provision and financing is available in the next section of this chapter.

ACCESS – USE OF HEALTH SERVICES

General practitioners (GPs) are the most used health service providers in Australia. In 2010–11, an estimated 14.5 million people aged 15 years and over (82%) had seen a GP at least once in the previous year, with 11.8 million seeing a GP more than once. Females in every age group were more likely to have seen a GP than males, particularly in the younger age groups (graph 11.22). During 2010–11, 12 million people aged 15 years and over were prescribed medication by a GP, and 6.1 million were referred to a medical specialist. Just over one million people had seen a GP after hours (8%).

GP visits were not necessarily remedial.In 2007–08, 65% of Australians aged 15 years and over had been to a GP for a check-up, rising to 95% for people aged 75 years and over (graph 11.23).

In 2010–11, an estimated 2.7 million people saw a GP for urgent medical care, mostly within four hours of trying to make an appointment (60%). However, nearly 10% of these people did not see a GP until two or more days after first trying to make an appointment. (Note that the definition of ‘urgent’ was left up to the respondent, but discretionary advice from interviewers was that it should include such things as a rash or fever, and exclude visits to get a certificate for work.)

Approximately 2.3 million Australians (13%) had been admitted to hospital in the previous year, 25% of these more than once. About 2.4 million people had visited a hospital emergency department (ED), 28% of them multiple times. People in outer regional and remote areas of Australia were more likely to report visiting an ED (18%) than those in urban areas (12%).

Just under half of people aged 15 years and over reported having a pathology test (49%) in the previous year, and nearly a third reported having an imaging test (32%). Females were more likely to have had diagnostic testing than males.

UNMET NEED – GENERAL HEALTH SERVICES

In the ABS Patient Experience Survey of 2010–11, all respondents were asked whether there had been any time in the previous year that they had needed health care but could not obtain it. An estimated 2.6% of people reported that there had been times that they had been unable to access health services when they needed them. In 51% of cases, the health service unable to be accessed was a GP, with medical specialists (18%) and hospital care (16%) the next highest services.

The main reasons people gave for not being able to access health care when they needed it were 'waiting times too long or no appointments available' (49%) and 'no service available in the area at the time it was needed' (25%).

BARRIERS TO HEALTH SERVICE USE

Availability

In 2009, 3% of people aged 15 years or over said that they had not been able to see a GP after hours when they had needed to.

In 2010–11, around 21% of people who had visited an ED thought, at the time of visiting, that the care they needed could have been provided by a GP instead. All people who had visited a hospital emergency department in the previous year were asked why they went to an ED rather than a GP, and 29% said it was due to the time of day or day of week that they needed care. Half of the people who visited an ED (49%) reported attending because they considered their condition to be serious or life threatening.

Financial barriers

While health service expenses in Australia are generally at least partly covered by Medicare, some people who needed health services found cost a barrier. In the 2010–11 PEx, need for health services was determined as follows:

General practitioner: people who had seen or said they needed to see a GP at some time in the previous year

Medical specialist: people who had been referred to a specialist or said they needed to see a specialist at some time in the previous year

Dental professional: People who had seen, or said they needed to see, a dental professional at some time in the previous year

Prescription for medication: people who had been prescribed medication or said they needed prescribed medication at some time in the previous year

Pathology and imaging tests: people who had been tested, or been referred for a pathology or imaging test, or said they needed a test at some time in the previous year.

In the 2010–11 PEx, all people aged 15 years and over who needed selected health serviceswere asked if they had delayed receiving or had not received that service due to cost. Rates of people finding cost a barrier differed across service types, as shown in table 11.24.

11.24 PERSONS WHO NEEDED HEALTH SERVICES(a), But delayed accessing or did not access service due to cost(b)

Type of service

'000

% who needed service

General practitioner

1 205.4

8.2

Medical specialist

809.9

11.9

Dental professional

2 676.0

26.0

Prescription for medication

1 143.9

9.2

Pathology test

257.6

2.9

Imaging test

366.7

6.3

(a) Persons aged 15 years and over who had used, or said they needed to use, selected health services.

In 2010–11, around 2.2 million people who had seen a GP (15%) felt that they had waited longer than was acceptable to get an appointment with a GP at some time in the previous year, with more females than males finding the waiting time unacceptable (17% and 13% respectively). Just under 453,000 people who had seen a GP (3%) had to travel more than one hour to see one.

One in five people who were referred to a medical specialist (21%) felt that they had waited longer than was acceptable to see a specialist at some time in the previous year.

EXPERIENCED HARM OR A HARMFUL SIDE-EFFECT

In 2009, over 5% of people aged 15 years and over reported having medication, medical care, treatment or a test that had caused harm or a harmful side-effect at some time in the previous year. Just over half of these people (55%) said that they had been informed of the risk that the harm or side-effect might occur. Around three-quarters of the people who had experienced harm or a harmful side-effect went to a health professional for their symptoms (74% or 658,600 people).

HEALTH SERVICE USAGE OF PEOPLE WITH A DISABILITY

People with a profound or severe disability were much higher users of health services than people without a disability. In 2007–08, people aged 15–64 years with a severe or profound disability were:

10 times more likely to have check-ups with a GP at least once a month than people without a disability (29% compared with 3%)

three and a half times more likely to consult medical specialists (56% compared with 16%), and

five times more likely to consult both specialists and other health professionals, particularly occupational therapists, and social or welfare workers (41% compared with 8% of people without a disability) (AIHW, 2011h).

HEALTH-RELATED ADVICE FROM PHARMACISTS

Pharmacists are allied health professionals who focus on safe and effective medication use; however, their role often includes provision of health-related patient care and advice. In 2009, an estimated 23% of Australians aged 15 years or over reported asking a pharmacist for health-related advice (not necessarily for their own health). The majority of these people (79%) reported that the advice met their needs completely and a further 18% reported that it met their needs to some extent.

Overall, females were more likely to have asked for advice than males, particularly in younger age groups (graph 11.25).

Statistics contained in the Year Book are the most recent available at the time of preparation. In many cases, the ABS website and the websites of other organisations provide access to more recent data. Each Year Book table or graph and the bibliography at the end of each chapter provides hyperlinks to the most up to date data release where available.